A 2013 survey by the Kaiser Family Foundation conducted just before the ACA’s major coverage expansion found that 40 percent of women with low incomes were uninsured. More than one-third of Latina women and nearly a quarter of Black women lacked coverage. Chris Schneider/Getty Images

The state-by-state analysis by the National Women’s Law Center (NWLC) found the ACA’s repeal would most imperil the coverage of women enrolled in Medicaid, including working women insured through Medicaid and women of color. The Republican repeal effort would hurt women across partisan lines, jeopardizing women’s insurance coverage in red and blue states alike.

“The attempt to repeal the Affordable Care Act is not taking into account the disproportionally harmful effect repeal would have on women, and especially women of color,” Gretchen Borchelt, vice president for reproductive rights and health with NWLC, told Rewire. “The bottom line is we know the ACA has changed the landscape for women and their ability to get insurance.”

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A 2013 survey by the Kaiser Family Foundation conducted just before the ACA’s major coverage expansion found that 40 percent of women with low incomes were uninsured. More than one-third of Latina women and nearly a quarter of Black women lacked coverage.

Today, about 28 million Americans lack health insurance, down from 41.3 million in 2013, when former President Obama’s signature health-care reform law kicked into gear.

The NWLC analyzed three years of census data on women ages 18-to-64 beginning in 2013, when the ACA rollout was kicking into high gear. They found women enjoyed double-digit gains in insurance coverage in red and blue states, such as Nevada (19 percent), California (17 percent), Kentucky (16 percent), Oregon (15 percent), and West Virginia (15 percent).

The ACA’s gains have been broad. The NWLC found that nearly all women in five states and the District of Columbia have health insurance, and more than 90 percent of women in the majority of states had health coverage in 2015.

In states where lawmakers expanded access to Medicaid, 3.9 million women enrolled in the government insurance program between 2013 and 2015, a growth of nearly 30 percent.

Women of color enjoyed double-digit gains in insurance coverage in every state except five from 2013 to 2015. Women of color gained insurance even in states where GOP-majority legislatures rejected Medicaid expansion, such as Florida, where more than 460,000 women of color became insured under the ACA.

“It’s likely that growth came because coverage became affordable through the ACA,” Borchelt explained.

The ACA offers insurance subsidies and prohibits gender-based pricing, among other provisions, that help reduce consumer costs.